1 Are all claims sent
electronically?
Claims are
transmitted to
carriers that are
able to receive
electronically. To
date, not all
carriers or IPA's
are able to receive
electronically.
2 Does the payment go to the
provider or the billing service?
All payments
typically go to
either the
provider's office or
a designated
lockbox. Money is
never deposited by
PMEB. In some
circumstances the
provider may use
PMEB as a mailing
address for
payments. When
payment is received
at the PMEB office,
it is forwarded to
the provider's bank
or the provider as
determined by the
provider.
3 Who will work on my account?
There will be one
person chosen to
manage your account.
However, PMEB has a
staff of people who
will be able to
answer calls and
questions from your
staff or patients.
You will always have
the option to talk
to the department
supervisor or
manager.
4 Do I have to use all of
your services?
No. Not every
practice requires or
requests all of our
services. We will
discuss your needs
and our services and
find the perfect
match.
5 How do I get the work to you?
The work from your
office can be sent
via mail,
PMEB’s FTP site,
overnight,
email or fax (only
for smaller
amounts). Whatever
resources are
available to you for
sending the work to
us will be fine with
us.
6 What are your hours?
Our business hours
are 8:30 - 5:00 CT
Monday - Friday.
7 Will I receive any
reports?
There are several
reports that are
provided monthly.
During our
discussions we will
determine if there
are any additional
reports that you may
require.
8 How much do you charge?
Once it is
identified as to
your needs, the
specific charges are
identified.
Typically we charge
on a percent of
collections.
9 Do I have to buy any
software for my office?
No. We generally
receive either hard
copy or electronic
files from your
office. The data is
entered into our
software and
transmitted to the
clearinghouse/insurance
carrier. No
additional software
purchases are
required for your
office.
10 Will I be required to use
any special forms?
As long as the
information we need
to produce your
claims is available
on your current
forms, there is no
need to change.
However, we will
recommend forms for
your use if we are
able to reduce the
amount of paperwork
necessary for your
staff to send to us
for billing.
11 Who is responsible for the coding?
The provider's
office is generally
responsible for the
coding. The provider
is the one who saw
the patient and
would know the
diagnosis and
procedures
performed. We will
assist in coding
guidance but will
require diagnosis
and procedure codes
from the provider.
There are special
arrangements for EMS
providers regarding
coding.
12 Who sets my fee schedule?
You determine the
fees you will be
charging. We will
assist or guide you
to confirm that you
are charging
appropriately.
13 What happens to a claim that
is not paid or denied by
insurance?
A/R recovery for the
claims filed by PMEB
is covered in the
fees charged to the
provider. We deal
directly with the
insurance companies
to determine claim
status and resubmit
if necessary. There
is no additional
charge for this
service.
14 Does PMEB bill the
patients for any balances that
are patient responsibility?
Yes. Unless the
provider specifies
that they will
collect all of the
patient portions
in-house, PMEB will
be sending patient
statements monthly
(or as specified).
15 Will PMEB help me with my
Medicare application?
PMEB has experience
with many of the
Medicare and
Medicaid
applications. There
is a separate charge
for assistance with
the applications.
16 What happens when
information is missing on the
work sent to PMEB for
processing?
The PMEB staff is
trained to watch for
errors or missing
information on the
data sent from the
provider's office. A
list of questions
will be sent back to
the provider
requesting more
information before
the specific claim
will be submitted to
the insurance
carrier.
17 Are there any additional
fees?
There is an initial
or set-up charge. In
addition, should the
provider request
assistance with any
Medicare or Medicaid
application, there
is an additional
fee.
18 Will PMEB be able to connect
to my EHR/EMR software?
PMEB has worked with
several EHR/EMR
systems. We will
work out the details
on acquiring the
data from your
system
19 Do we send the claims
directly to the insurance
company?
PMEB transmits
claims to a
clearinghouse. The
clearinghouse
performs additional
front-end edits
before claims are
forwarded to the
insurance carriers.
20 Is PMEB accepting new
clients?
Yes. PMEB is always
open to new
providers of all
specialties.
